Tuesday, 2 December 2008

Depressing Facts about Abortion

From the Herald (who has taken a break from lambasting pregnant women for wearing toxic make up ( because apparently women wearing toxic chemicals is fine if they aren't knocked up) and the list of food pregnant women will be bitched out about enjoying now includes coffee)

First up I hate the term pro-abortion. Pro-choice is very different from being pro-abortion. So let me spell out the pro-choice position. Just because we think it should be an option doesn’t mean we advocate that anyone should go along that path because actually we would prefer that there were no unplanned pregnancies through better use of contraception. We merely believed that abortion should be there as an option for those who want it.

Hence why Pro-choicers find China’s state enforced-abortions just as abhorrent as the situation in El Salvador where women are subjected to enforced vaginal examinations and incarceration if an underground abortion is suspected and where the well-off still exercise their choice via a plane ticket to the States or a discreet doctor. For pro-choicers it is an issue of body autonomy as well as choice. We believe that the person best placed to make the decision as whether or not to have a child or adopt it or abort it is the woman who will carry the baby with (ideally but not always practical) her partner in consultation with health professionals.

While abortion may have mental health consequences, none of the choices regarding an unplanned pregnancy are entirely physically and mentally risk free nor are they always pleasant. That's the thing about freedom, sometimes you are going to make decisions that have bad consequences. Like women who might delay having kids until it is 'too late' or teens who become mums 'too early,' these are decisions that have huge impacts on their physical and mental well-being but that this is their decision to make. Thus I'm not going to dictate which decision is right for a woman who just got an unexpected positive pregnancy test. If they want a child, that's great babies and kiddies are awesome. If they are keen on doing a Juno, that's awesome too. If they want an abortion, then I say right on for making the decision that's right for them.

This study is being used as further fuel to actually enforce or regress New Zealand's abortion laws. Like many pro-life activists, I actually agree that the current legislation is a farce. Where we differ is that I believe that abortion in New Zealand should be fully decriminalized. Perhaps something along the lines of what was recently passed in Victoria. Where it is on demand until 12 weeks and then requires two doctors to sign off after 20.

The problem with abortion is that it isn’t an issue where we can say "let’s agree to disagree." It fucks around with real people’s lives; their futures, their sense of security and happiness on the basis of a question (when does life begin) that hasn’t been answered fully by science nor for that matter philosophy. For some people life with full rights begins at conception, others around the start of the second trimester others around the time that the fetus can live without the assistance of the mother. I respect that some segments of society have very different views on abortion from my own and would never undergo one due to their beliefs.

The problem I have with their position is when they enforce their beliefs about when life starts upon me and labeling my decisions as being evil or murderous it's enough to make me very depressed.


captiver said...

I am enjoying your blog. Among the problems with the latest study "linking" abortion to depression is that it, of course, focuses on women who had abortions. The more relevant study for abortion rights - but one that could not be carried out since it would be hideous and unethical - would be on women forced to bear children against their will? That is, is there a link between women denied abortions and depression?

Anna said...

Glad you're enjoying the blog Captiver! I agree with you completely about the problems of implying that abortion causes depression.

How about the effects on women who've had abortions of the negative views which are propounded about them and their morality? Is the tendency to depression perhaps their in the first place, and linked to the likelihood that women become pregnant and require abortions?

Anna said...
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Tidge said...

Another problem with this study is that it a) involved only 6 interviews over something like 25 years, and b) considering that one of the 'reasons' for having an abortion in New Zealand is that not having one may endanger one's mental health, I'd be interested to see what proportion of these women had a pre-history of mental illness.

Hayward said...

Heck, what is the general rate of "mental disorders" among women who have had children full-stop? And is it higher or lower than that rate "linked" to abortion? Can we get a reading on how many mental disorders are caused by converting to christianity now please?

The study sounds remarkably dodge to me (at least from the way Teh Herald reports it), but what also sets off alarm bells is:

1. they give a percentage rate of mental disorder that they attribute to abortion - but don't quantify the actual number (if it's 5-10 people a year, is it really that significant?); and 2. They don't provide a definition for mental disorders caused in the article. Are we talking mild and transitory depression or full-blown schizophrenia?

Christina said...

you can view the abstract of the study online at http://bjp.rcpsych.org/cgi/content/abstract/193/6/444?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=david+fergusson&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
I understand that the Christchurch Health and Development study is generally quite highly regarded, and its longitudinal nature (e.g. the participants have been followed from birth) means they generally do adjust for confounds such as pre-existing conditions - hopefully someone with access to BJP (maybe via a university library) could review and confirm if this was the case here?

Joanna said...

Oh also, if you have an abortion, you waive your right to complain about violence, and are in fact, asking for it. UGH.

captiver said...

Some points on the Fergusson et al study gleaned from reading the study, and the commentaries (in the same issue of the journal) and checking out some current and previous critiques by ALRANZ. I'm not fully equipped to critique the data sets in the study, I'm afraid and what follows is no doubt more than anyone wanted to know, but:

From ALRANZ (Abortion Law Reform Association of NZ): “The findings are based on a relatively small sample of women having abortions and do not make allowances for all of the confounding factors. There is insufficient information on the context in which the abortion occurred, a reliance on self-reported outcomes and under-reporting of abortion experiences.” [Fergusson et al say they have considered over 30 confounding variables. I won't list them here.]

Above seems to be backed up by the authors themselves: From the Fergusson et al study: “Although the weight of the evidence favours the view that abortion has a small causal effect on mental health problems, other explanations remain possible. In particular it could be suggested that the small association between abortion and mental health found in this study could be explained by uncontrolled residual confounding.”

Three of the commentators on this paper [writing in the same Dec. 08 British Journal of Psychiatry as the study, Margaret Oates, Ian Jones and Roch Cantwell] say (speaking perhaps to Hayward's point): “It would be remarkable if abortion was not associated with a rise in distress and even episodes of anxiety and depression: all other gynaecological and reproductive events, and most surgical procedures, are, as indeed are life events.”

A previous study by Fergusson has faced criticism. Visit:
and Margaret Sparrow's analysis is
on the front page under "abortion and mental health."

As ALRANZ pointed out, the recent American Psychological Association Task Force on Mental Health and Abortion (which found there was no credible evidence that a single abortion is a threat to a woman’s mental health) called for better designed future research. The task force observed that many of the studies, including that previous study from Fergusson et al, all suffered from methodological problems. Several commentators and critics in New Zealand have noted that in this new paper, Fergusson et al have corrected some, but not all of the problems.

One is the measurement of mental disorder. One critic has noted that the measurement of mental disorder is only a proxy measure and that proper data would need to include hospital admissions, doctor visits, diagnosis by psychiatrist etc. The study does not have this data.

The alleged mental health disorders are called “mild” by the three commentators and the authors of the study argue that the results do not support the position that “abortion has large and devastating effects on the mental health of women.” In their press release, the authors say: “The conditions most associated with abortion included anxiety disorders and substance use.”

Oates, Jones and Cantwell in their commentary have this very pertinent comment: “The cohort size did not allow for any examination of the risk of serious mental illness. The modest increase in risk of mild problems might be accounted for by ‘a minority of women [for whom] abortion is a highly stressful life event which evokes distress, guilt and other negative feelings that may last for many years’. Unfortunately they did not identify who this minority of women might be. Research suggests that women with multiple pregnancy loss and those who have a late termination for foetal abnormality face an increased risk of mental health problems. Could this account for the increased risk identified in this paper?”

This commentary also points out that since it will never be possible ethically to conduct randomised controlled trials that include women forced to continue with an unwanted pregnancy, research is unlikely to be able to resolve “whether or not abortion causes more mental health problems than continuing with a pregnancy.”